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Testosterone Low? Here's How to Find Out

Screening tool could lead to treatment for millions of men

SATURDAY, Sept. 8, 2001 (HealthDayNews) -- If you're a man aged 40 or older and you suffer from low libido, lack of energy, depression, or find yourself falling asleep after dinner, low testosterone levels could be to blame.

But a simple new questionnaire could help determine whether that's the case.

Recognizing the warning signs of low testosterone is an important step in helping aging men maintain their health, says Dr. John Morley, a gerontology professor and director of the geriatric medicine division at St. Louis University School of Medicine. Morley developed the survey, which he calls the Androgen Deficiency in Aging Men (ADAM) questionnaire.

The 10 simple questions act as a screening tool to encourage men to talk to their doctors about the condition and to determine if they should have their testosterone levels checked and whether they're candidates for testosterone replacement therapy.

"It's a very common problem, but you can't go do relatively expensive hormone tests on everybody who's over the age of 40 every six months," says Morley. "It starts to become very expensive. So the questionnaire was a way to try to see if we could pick up symptoms that would make it worthwhile to pursue doing some of the more expensive testing."

He says he selected the questions based on what he'd learned from his own patients about signs and symptoms of low testosterone.

The questionnaire isn't just for men, however. Women also can review the questions to see if the men in their lives show signs of low testosterone, Morley says. In fact, he says, about half the men who come to his clinic are there because their wives looked at the questionnaire and recognized a problem.

The U.S. Food and Drug Administration estimates that 4 million to 5 million American men may suffer from low testosterone, but only 5 percent are treated.

Testosterone treatment is effective for most men, and about 70 percent of them continue treatment once they try it, Morley says.

"Where it works, it makes a huge difference to the person's quality of life," he says.

But it's a lifetime commitment.

"If you want the symptoms to be better, you almost certainly have to do if for the remainder of your life," Morley says. "It's very much like replacing estrogen in menopause [for women]. The difference is the menopausal symptoms tend to disappear, whereas the male andropause symptoms sort of stick around."

In the United States, testosterone-replacement therapy can be done with injections, skin patches or skin gel. There is a pill, but it's not approved in the United States.

Dr. Christopher Steidle, a urologist and associate clinical professor at Indiana University School of Medicine, says he considers the questionnaire a great screening tool.

It adorns a poster in his office and also is on sheets filled out by new patients.

"What's so very dramatic is that the majority of men who have low testosterone immediately recognize themselves when they see the questionnaire," Steidle says.

"It's allowed us to effectively and rapidly look for men who may not know that it's a problem," he says. "They may think it's normal to be grumpy and fall asleep after supper and have no erections and no zest. Then they suddenly realize that this is a problem, this is a real thing."

The questionnaire also makes it easier for men to broach a difficult topic and discuss it with their doctor, Steidle says.

What To Do

Here's the questionnaire. If you answer "yes" to the first seven questions, or "yes" to three or more questions overall, Morley suggests you make an appointment with your doctor to discuss the results.

  • Do you have a decrease in libido (sex drive)?

  • Do you have a lack of energy?

  • Do you have a decrease in strength and/or endurance?

  • Have you lost height?

  • Have you noticed a decreased "enjoyment of life?"

  • Are you sad and/or grumpy?

  • Are your erections less strong?

  • Have you noticed a recent deterioration in your ability to play sports?

  • Are you falling asleep after dinner?

  • Has there been a recent deterioration in your work performance?

To learn more about low testosterone, visit the Hormone Foundation online. And for more information on andropause, sometimes called male menopause, try the Andropause Canada Web site.

SOURCES: Interviews with John Morley, M.D., director, Division of Geriatric Medicine, and professor of gerontology, St. Louis University School of Medicine, St. Louis; and Christopher Steidle, M.D., urologist, associate clinical professor, Indiana University School of Medicine, Fort Wayne, Ind.
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